Use of Pharmacotherapy with High-Risk Offenders (From Managing High-Risk Sex Offenders in the Community: Risk Management, Treatment and Social Responsibility, P 105-132, 2010, Karen Harrison, ed. - See NCJ-230796)

• NCJ Number: 230802
• Author(s): Karen Harrison
• Date Published: 2010
• Length: 28 pages
• Sale Source: Willan Publishing
• Publication Format: Book Chapter
• Publication Type: Issue Overview
• Language: English
• Country: United Kingdom

Annotation

This chapter focuses on the use of pharmacotherapy in treating high-risk sex offenders, with a brief mention of forms of neurosurgery and surgical castration.

Abstract

In contrast to the aforementioned invasive surgical interventions, pharmacotherapy uses medication to treat sex offenders in order to achieve the effect of surgical castration, but through less invasive and irreversible means. This chapter explains the effects of the medications used, how these effects are achieved, their effectiveness, and their current use in England and Wales. It also considers some of the ethical and legal issues involved in pharmacotherapy, such as whether the treatment should be voluntary or mandatory; whether it should be classified as treatment rather than punishment; and treatment cost. The chapter describes and compares the following medications intended to reduce sexual desire: medroxyprogesterone acetate (MPA), cyproterone acetate (CPA), luteinizing hormone-releasing hormone (LHRH) inhibitors, and gonadotrophin-releasing hormones (GnRH) agonists. Other types of medications reviewed are psychotropic medication and selective serotonin reuptake inhibitors (SSRIs). Given the different types of drugs available and within each type the variety of medications that can be used, it is difficult for practitioners to know which type of drug and, within that category, which actual medication is the best for their individual patient. This chapter presents a graphic portrayal of a hierarchy of medication for controlling mild, moderate, and severe sexually deviant behavior. One section of the chapter reviews the previous and current use of pharmacotherapy with sex offenders in England and Wales. Currently, the role of referral for sex offender medication has been given to the Ministry of Justice through the National Offender Management Service (NOMS). Although an absolute right to treatment does not exist in England and Wales, this chapter recommends providing it for those who need it, so that initial offending can be prevented. 1 figure, 3 notes, and 91 references